References

British Association of Dermatologists. Referrals Urticaria. 2024. https://www.bad.org.uk/referrals/urticaria (accessed 12 November 2024)

Chronic spontaneous urticaria. 2018a. https://dermnetnz.org/topics/chronic-spontaneous-urticaria (accessed 12 November 2024)

Chronic inducible urticaria. 2018b. https://dermnetnz.org/topics/chronic-inducible-urticaria (accessed 12 November 2024)

BMJ Best Practice. Assessment of Urticaria. BMJ Best Practice. 2023a. https://bestpractice.bmj.com/topics/en-gb/210 (accessed 12 November 2024)

BMJ Best Practice. Urticaria and angio-oedema. BMJ Best Practice. 2023b. https://bestpractice.bmj.com/topics/en-gb/844#:~:text=Summary,reaction%20to%20a%20specific%20trigger (accessed 12 November 2024)

Champion RH, Roberts SO, Carpenter RG, Roger JH Urticaria and angio-oedema. A review of 554 patients. Br J Dermatol. 1969; 81:(8)588-97 https://doi.org/10.1111/j.1365-2133.1969.tb16041.x

Chronic Urticaria. 2021. https://emedicine.medscape.com/article/1050052-overview (accessed 12 November 2024)

Humphreys F, Hunter JA The characteristics of urticaria in 390 patients. Br J Dermatol. 1998; 138:(4)635-8 https://doi.org/10.1046/j.1365-2133.1998.02175.x

Kolkhir P, Bonnekoh H, Metz M, Maurer M Chronic Spontaneous Urticaria: A Review. JAMA. 2024; 332:(17)1464-1477 https://doi.org/10.1001/jama.2024.15568

Angioedema. 2022. https://dermnetnz.org/topics/angioedema (accessed 12 November 2024)

National Institute for Health and Care Excellence. Urticaria. 2024. https://cks.nice.org.uk/topics/urticaria (accessed 12 November 2024)

Primary Care Dermatology Society. Urticaria: chronic spontaneous urticaria (chronic ordinary urticaria; chronic idiopathic urticaria). 2022a. https://www.pcds.org.uk/clinical-guidance/urticaria-spontaneous-syn-chronic-ordinary-urticaria (accessed 12 November 2024)

Primary Care Dermatology Society. Urticaria: chronic inducible urticaria (eg pressure, cholinergic, contact, aquagenic). 2022b. https://www.pcds.org.uk/clinical-guidance/urticaria-physical-urticaria (accessed 12 November 2024)

Sabroe RA, Lawlor F, Grattan CEH British Association of Dermatologists guidelines for the management of people with chronic urticaria 2021. Br J Dermatol. 2022; 186:(3)398-413 https://doi.org/10.1111/bjd.20892

Effective management of chronic urticaria

02 January 2025
Volume 7 · Issue 1

Abstract

Urticaria (also known as welts, hives, weals, wheals or nettle rash) is usually divided into acute and chronic forms, becoming chronic when daily or almost daily wheals continue for 6 weeks or more, although many attacks of acute urticaria settle much more quickly. The most common underlying mechanism is the release of histamine from mast cells with consequent capillary dilatation and tissue oedema. In the UK, approximately 15% of people experience urticaria at some time in their lives and for around 40–50% of people with urticaria, the cause of their condition is unknown. This article will provide an overview of chronic urticaria to include the clinical signs, history, diagnosis and management principles, signposting to current guidance, patient information and further resources.

Urticaria (also known as hives, weals, wheals or nettle rash) is a superficial swelling of the skin (epidermis and mucous membranes) that results in a red, raised, and intensely itchy rash (National Institute for Health and Care Excellence (NICE), 2024). It is usually divided into acute and chronic forms, becoming chronic when daily, or almost daily, wheals continue for 6 weeks or more, although many attacks of acute urticaria settle much more quickly (Sabroe et al, 2022). An estimated 40% of patients with chronic urticaria also have associated angio-oedema (Morley, 2022). The most common underlying mechanism is the release of histamine from mast cells with consequent capillary dilatation and tissue oedema.

In the UK, approximately 15% of people experience urticaria at some time in their lives and, for around 40–50% of people with urticaria, the cause of their condition is unknown (British Association of Dermatologists (BAD), 2024)

Register now to continue reading

Thank you for visiting Journal of Prescribing Practice and reading some of our peer-reviewed resources for prescribing professionals. To read more, please register today. You’ll enjoy the following great benefits:

What's included

  • Limited access to our clinical or professional articles

  • New content and clinical newsletter updates each month